Good practices in collecting umbilical cord and placental blood

Inconsistencies in Pregnant Mothers' Attitudes and Willingness to Donate Umbilical Cord Stem Cells: A Cross-Sectional Analysis from Saudi Arabia

The collection and storage of umbilical cord stem cells (UCSCs) have a crucial role in improving and expanding stem cell-based therapies, which are becoming popular in Saudi Arabia and other Middle East countries. Many patients and families in Saudi Arabia depend on private cord banks in foreign countries to purchase stem cells, which has financial and medical implications. The current study aims at determining the predictors of current registration status and willingness to donate cord blood stem cells among expectant mothers in Saudi Arabia. A cross-sectional study collected data from 714 expectant mothers from all thirteen regions of Saudi Arabia in December 2022. The online survey questionnaire assessed women's awareness, direct and indirect exposure to stem-cell therapy, sources of knowledge, willingness, reluctance, and current registration status to donate cord blood. Although women demonstrated higher acceptance and lower rejection towards the donation of UCSCs, just one percent (n = 7; 1%) of expectant mothers in this sample are registered with the Saudi Stem Cell Registry. Overall, 48% indicated their willingness to register in the future. Both correlational analysis and multiple regression analysis demonstrated that awareness significantly predicted willingness to donate (p < 0.01), and rejection attitudes were negatively related to willingness to donate (p < 0.001). Although the mean scores on acceptance were high, they were not found to be significantly associated with willingness to donate. Prior direct and indirect exposure to stem cell therapy appeared to be the strongest predictor of pregnant women's willingness to register (p < 0.001). Findings suggest that acceptance attitudes do not have a symmetrical relationship with intention. Women's prior exposure to stem cell therapy was the most significant factor; therefore, findings demonstrate that currently women are relying on their firsthand experience to decide about cord blood donation rather than the information obtained from other sources, such as social media and the internet. Though attitudes were not identified as significant predictors in the statistical models, awareness was a relevant factor, and the findings signify increasing awareness in various target populations to enhance the probability of intention to donate cord stem cells.

Pulsatility of the umbilical cord in full-term natural childbirths

OBJECTIVE

Measure umbilical cord pulsatility time and evaluate correlation/association with maternal and neonatal characteristics.

METHOD

Cross-sectional study, with 76 binomials, carried out in 2017, in a maternity hospital in Alagoas. Analysis with Pearson or Spearman correlation test and Mann-Whitney or Kruskal-Wallis test.

RESULTS

Sixty-two parturients and their newborns participated of the research. The women had a gestational age ≥ 37 weeks, natural cephalic birth, without distortions. The newborns had average weight of 3326.29g, mostly male. The umbilical cord pulsatility time was 285.48s. There is a correlation between umbilical cord pulsatility time and placental delivery time (p<0.001). Other correlations/associations were not significant.

CONCLUSION

It suggested using a correlation between pulsatility time and placental delivery time in clinical decision making for good practices in childbirth assistance.

Development and validation of a technology for obstetric intraoperative care safety

OBJECTIVES

to develop and validate an obstetric surgical safety checklist for intraoperative care.

METHODS

this is a methodological study with two phases: integrative review in databases, using selection criteria and descriptors to synthesize the evidence and develop the checklist; checklist content validation, with 37 judges, who answered a Likert-type questionnaire. For analysis, a >85% content validation index was applied.

RESULTS

the checklist's first moment reached a 96.1 content validation index; the second moment, 95.5; the third moment, 98.9. Thus, the validation index of all verifying sections present in the three surgical moments was 97.1. Cronbach's Alpha value was 95.57%.

CONCLUSIONS

the checklist items were validated by judges, with improvement of some items and insertion of others.

Umbilical Cord Blood Screening for the Detection of Common Deletional Mutations of α-Thalassemia in Bangladesh

α-Thalassemia (α-thal) is assumed to be very prevalent in Bangladesh. We aimed to assess the prevalence of the disease in the country and provide a model for α-thal newborn screening in Bangladesh. We collected umbilical cord blood (UCB) samples from 413 unrelated newborns in Bangladesh. Demographic information, blood indices, osmotic fragility, serum iron (Fe), and zinc (Zn) levels were evaluated for all the subjects. All subjects underwent a polymerase chain reaction (PCR)-based diagnosis for α-thal status, followed by a multiplex gap-PCR-based identification of the deletion type present. Sixty-seven subjects had at least one α-thal deletion (16.22%). We observed that -α^3.7 (rightward), - -^SEA (Southeast Asian), -α^4.2 (leftward), - -^MED (Mediterranean) and - -^THAI (Thailand) deletions were the most common α-globin deletions present in the country, with the -α^3.7 (n = 37) and - -^SEA (n = 18) being most prevalent. The osmotic fragility test (OFT) could predict the presence of α-thal deletions with over 98.0% sensitivity. Complete UCB count analysis revealed significant differences between healthy subjects and subjects with α-thal deletions. Although the iron level was almost the same (108.0 vs. 105.7 µg/dL), a reduced level of Zn (98.6 vs. 71.8 µg/dL, p < 0.01) was observed in the cord blood-derived serum of the subjects with α-thal deletions. Moreover, parental age at the time of delivery, gestational period, and birth weight was lower in the subjects with α-thal deletions. This study provides partial information on the epidemiology of α-thal in Bangladesh and describes a model for α-thal newborn screening in the country.